Diarrhoea in Childhood

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Abstract Diarrhoea may be defined as frequent passage of loose stools or, more accurately, passage of an increased volume of stool water. A stool volume of more than 200 ml/m2/day indicates diarrhoea, as does a stool weight of more than 150-200 g watery stool/m2/day. Such precise measurements are difficult to achieve in children, and infants would have to be admitted to a metabolic unit. Therefore, more practical definitions are required. • Diarrhoea in infancy and early childhood may be defined as an increase in stool frequency associated with a change to loose or watery stools. • It must be remembered that normal breast-fed infants may pass frequent loose stools. Diarrhoea in a breast-fed infant is defined as a departure from the normal stool pattern with increased volume and frequency. • Acute diarrhoea may be defined as diarrhoea of less than 2 weeks' duration. • Chronic diarrhoea is that of more than 2 weeks' duration. Diarrhoea in infancy and childhood has many causes, which vary geographically. Repeated bacterial infection is important in chronic diarrhoea in the developing world, but an uncommon cause in developed countries in the absence of underlying immunodeficiency. Rare intractable diarrhoea syndromes may require long-term parenteral nutrition, or even small intestinal transplantation.